ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2012
Distribution of coronary artery stenosis after radiation for breast cancer.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02571894 (Effects of Identifying and Treating Early, Subclinical Cardiotoxicity on the Long-Term Incidence of Clinical Cardiotoxicity in Women With Breast Cancer, A Prospective Randomized Study), which is not on this map. Cited by 141 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Identifying and Treating Early, Subclinical Cardiotoxicity on the Long-Term Incidence of Clinical Cardiotoxicity in Women With Breast Cancer, A Prospective Randomized Study: The Cardio-Oncology Breast Cancer Study (COBC)
Who cites it
141 citing papers in PubMed, 380 citations in OpenAlex.
- Usefulness of a thermoplastic breast bra for breast cancer radiotherapy : A prospective analysis.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2016Trial
- Early detection and prediction of cardiotoxicity after radiation therapy for breast cancer: the BACCARAT prospective cohort study.Radiation oncology (London, England) · 2016Trial
- Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation.Radiation oncology (London, England) · 2015Trial
- Is there a dose-response relationship for heart disease with low-dose radiation therapy?International journal of radiation oncology, biology, physics · 2013Trial
- Review
- Feasibility and trade-offs of incorporating cardiac substructure dose constraints in left-sided breast volumetric modulated arc therapy planning.Radiation oncology journal · 2026Article
- A neighborhood attention transformer network for enhanced 3D segmentation of the left anterior descending artery.Medical physics · 2026Article
- Comparison of surface-guided radiotherapy-based deep inspiration breath hold and continuous positive airway pressure techniques in left-sided breast cancer: dosimetric and workflow analysis.Physical and engineering sciences in medicine · 2026Article
- Optimizing Cardiac Dose Prediction in Left-Sided Breast Cancer Radiation Therapy: Clinical Strategies for Identifying Beneficiaries of the Deep Inspiration Breath-Hold Technique.Advances in radiation oncology · 2026Article
- Cardiac substructure dosimetry in thoracic radiotherapy: moving beyond mean heart dose and toward precision cardiac risk mitigation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Review
- Postoperative radiotherapy and external carotid artery diameter: is there a link to osseous free flap osteoradionecrosis risk?Clinical oral investigations · 2026Article
- Development of a model to guide the decision for radiotherapy in deep-inspiration breath-hold in patients with left-sided breast cancer.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Targeted delivery of liposomal senolytics to alleviate cellular senescence-induced bone loss.Fundamental research · 2025Article
- Radiation-induced cardiac substructure damage and dose constraints: a review.Radiation oncology (London, England) · 2025Review
- Effect of jaw width in jaw tracking mode on the radiotherapy dose of partial arc VMAT in patients undergoing left breast-conserving surgery.Scientific reports · 2025Article
- Article
- Cardiac substructure dose distributions in node-positive and node-negative breast cancer patients undergoing 3D-CRT: comparing the predictive accuracy of mean heart dose and mean left ventricular dose.Radiation oncology (London, England) · 2025Article
- Radiation-induced heart disease in breast cancer patients: a narrative review of epidemiology, risk factors, radiotherapy parameters, and prevention.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Review
- Cardiac Effects of Modern Breast Radiation Therapy in Patients Receiving Systemic Cancer Therapy.JACC. CardioOncology · 2025Article
- Imaging of the Acute and Chronic Cardiovascular Complications of Radiation Therapy.Circulation. Cardiovascular imaging · 2025Review
81 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
purposeTo study distribution of coronary artery stenosis among patients with breast cancer (BC) and to assess correlation between radiotherapy (RT) and location of stenosis. PATIENTS AND
methodsA Swedish BC cohort diagnosed from 1970 to 2003 was linked to registers of coronary angiography from 1990 to 2004, which yielded 199 patients. Stenoses of the coronary arteries were graded from 0 to 5, where 0 indicated a normal vessel and 5 indicated occlusion. Two hotspot areas for radiation were defined: proximal right coronary artery (prox RCA), mid and distal left anterior descending artery and distal diagonal (mdLAD + dD). RT regimens were categorized as high or low risk of irradiating the hotspot areas. Left breast/chest wall was considered high risk for mdLAD + dD; left internal mammary chain (IMC), high risk for prox RCA and mdLAD + dD from 1970 to 1995 and thereafter solely for mdLAD + dD; and right IMC, high risk for prox RCA. Other RT targets and no RT were considered low risk. Results were expressed in odds ratios (ORs) and 95% CIs.
resultsFor irradiated left- versus right-sided BC, the OR for grade 3 to 5 stenosis in mdLAD + dD was 4.38 (95% CI, 1.64 to 11.7), and for grade 4 to 5 stenosis, the OR was 7.22 (95% CI, 1.64 to 31.8). For high-risk RT versus low-risk or no RT, the OR for grade 3 to 5 stenosis in hotspot areas was 1.90 (95% CI, 1.11 to 3.24).
conclusionAn increase of stenosis in mdLAD + dD in irradiated left-sided BC and an association between high-risk RT and stenosis in hotspot areas for radiation indicate a direct link between radiation and location of coronary stenoses.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.